Individual provider Active NPI

Kyle Armstrong, DDS

  • Dentist
  • Auburn, NY
National Provider Identifier
1801417654
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
062146 Issued in NY
Practice address
306 Grant Ave
Auburn, NY 13021-1404
Phone
(315) 515-3015
NPI assigned
May 4, 2020
Last updated
Sep 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 062146 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

306 Grant Ave
Auburn, NY 13021-1404

Mailing address

83 New York Ave
Freeport, NY 11520-2018
Phone (718) 635-3688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
062146NYMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1801417654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 NEW YORK AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115202018",
            "telephone_number": "718-635-3688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 GRANT AVE",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211404",
            "telephone_number": "315-515-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARMSTRONG",
        "first_name": "KYLE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-04",
        "last_updated": "2022-09-21",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "062146",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.